A volunteer’s trip to Fort Portal International Nursing School (FINS), Uganda, March 2018

Well, it wasn’t a very auspicious start to my journey.  The BBC news was full of dramatic stories of accidents, travel chaos, school closures, train and flight cancellations, and people being stranded due to the cold weather and very heavy snow falls.  I decided to quickly rearrange my travel plans to arrive at Heathrow the night before my flight to make sure I didn’t miss it, and, as predicted, it was travel chaos with my booked train cancelled and also Paddington Station closed to the Heathrow Express. But I muddled through somehow and got to the Heathrow Premier Inn about 9pm to be greeted by a bloke on the door telling me that if I didn’t have a booking then I was out of luck as they were full.  (Obviously everyone had had the same idea as me). Fortunately, due to the wonders of the internet I had booked before I left home so I was let in.

In my room I checked through my luggage (for the umpteenth time) to make sure I had everything. ‘Passport, money, tickets’ Phew! all still there.  Then $50 for entry visa, anti-malaria tablets, enough medication to stock a small pharmacy (just in case!), yellow fever certificate, flight socks (very sexy), all my course notes, posters and materials, the items of medical equipment I was taking, clothes, kagoule, torch and spare batteries.  Yep! all there.  I could relax now and go for something to eat and phone the wife.


The flight next morning was on time.  Turkish Airlines, via Isatanbul and Kigale (Rwanda), to Entebbe. They were very nice flights, good planes, good service, good food, and some cracking films on the in-flight entertainment systems.                   

I arrived at Entebbe airport at 4am and, much to my relief, was greeted by the driver (arranged by Jas) holding my name up on a piece of card. Then a two-hour drive to the team’s apartment in Kampala arriving about 7am where Jas greeted me, made me a nice cup of tea and let me ‘crash’ on the sofa for an hour until the team woke up. A quick introduction to Ben and Lisa and breakfast, then I was kindly taken to my hotel so that I could shower and sleep after travelling for almost two days, while they went to visit The Equator. An interesting thing about the hotel was that there was a 1920’s flat tank Triumph motorbike in the lobby. It was exactly as found, rusty, but complete and fairly sound.  I couldn’t help wondering how on earth it had got there.  Presumably some old colonial type, maybe an army officer, shipped it across between the wars as his transport and play-thing? (very Lawrence of Arabia).                    

I was collected the following morning by Victor , the director of FINS, who drove me to Fort Portal,  with his wife, her sister, and not only my luggage but two sets of golf clubs and a considerable amount of their luggage too together with their shopping.  It’s fair to say that it was very ‘cosy’ in the car and a good job Victor didn’t want to look out of the rear window and that the ladies were close relatives!                

The road to Fort Portal, like all Ugandan roads, is in terrible condition.  Potholes everywhere, whole sections reduced to just mud and gravel, and things made worse by the Ugandan style of driving (choose your own adjective from: assertive, gung-ho, kamikaze, fearless, and ‘Driving lessons ??? What are those?), and also by the condition of the vehicles on the road, (ranging from dangerous to positively lethal),  and by the other road users, boda-boda motorcycles (in their tens of thousands,  and often carrying dangerous and loose loads like beds, wardrobes, four or more passengers, live animals, sheets of corrugated iron etc), pedestrians, children playing, cattle, goats, cyclists, and every few hundred yards a broken down vehicle surrounded by ‘helpers’. But after 5 hours we arrived safely.                

I think it’s fair to say that Uganda can often be an assault on the senses. The smell of burning banana trees, the pervading dust, the sounds of strange birdsong during the day and frogs and crickets at night, the hustle and bustle of street life late into the night.  But it was never a place where I felt threatened or in any danger (riding on boda-bodas being the one exception).                                

The currency took a bit of getting used to.  If you change two hundred pounds at the airport you are a Ugandan millionaire!!  My first restaurant meal of steak, chips and salad was 23,000 Ugandan Shillings !! with a Coke at a further 2,000 U/s.  It wasn’t until after I’d produced a wad of cash from my back pocket and settled up that I fully realised that I’d had a slap-up meal with drink for a fiver. On more than one occasion I tried offering ten-times the actual asking price, only to be corrected and the only correct money taken.                

My driver for the duration of my stay was Wilson, who would collect me from my motel at 8am to arrive at FINS for the start of my teaching day at 8.30am. I would set up my projector and laptop, and my teaching materials, and the medical equipment for that day’s practical session ready for the students who would drift in between 8.15 and 9am.

I think the secret of teaching in Uganda (or any hot country for that matter) is to do the theory work in the morning, and to do the practical and hands-on sessions in the afternoon.  If you try to do too much chalk-and-talk after lunch you risk losing your audience, as they tend to nod-off to sleep! (due to full stomachs, hot humid weather, and being tired . . . nothing to do with my teaching . . . I hope!)                  

I was teaching for two weeks.  The first week was to 3rd year students who were to sit their State Final exams in two months time and were at the end of their studies.  The second week I was teaching second year students who had another year of study ahead.  Both classes were of over 100 students, a mixture of student nurses and student midwives, and I would regularly have over 80 students in a class.                    

I found the students to be polite, friendly, well behaved, studious, kind, hard working and very grateful for any help or encouragement.  It was a privilege to teach them.                  

The Amalthea Trust aims to provide for the sustainable maintenance of medical equipment through the provision of training programmes. Normally this is done by training engineers, and particularly university under graduates.  However, the philosophy behind the training I was providing to future nurses was that if they understood how the equipment worked, appreciated how important the care and correct use was to the life of the equipment, and knew how to use and look after it correctly, then there should be fewer breakdowns and any measurements would be more accurate.  This should mean longer, more reliable life of the equipment and better outcomes for the patient.                    

Consequently, my training firstly explained how the equipment worked, and the science behind its operation.  Then we would focus on how to use the equipment correctly and the importance of preparing both the equipment and the patient.  We would discuss operating techniques, consumables, safety considerations, infection risks, and other factors that would affect accurate results.  We would discuss common faults, how to rectify or report problems, and how to care for and keep the equipment ‘fit for purpose’. And finally, we would have practical sessions where the students could use the equipment, and take some basic physiological measurements of each other.                    

The Amalthea Trust have provided FINS with a range of medical equipment for training purposes: (InfusionPump, Syringe Pump, Defibrillator, Multi-parameter Monitors, CardioTocoGraphs, Ventilator, and an incubator) and I took with me some NIBP monitors, Pulse Oximeters, Thermometers, and Sphygs, so the students had exposure to a wide variety of medical equipment during the sessions.                    

I was also able to answer questions on and explain some other items of medical equipment.  The students wanted to know about CT Scanners, Surgical Diathermy and Dialysis amongst other things. We also shared about life and culture in our different countries.  The students were very interested in life in UK and in the wider world. The students had not received any careers advice during their training, so I was able to pass on some advice about writing CV’s, choosing the right job, and interview preparation which they found very useful. Because the students have very limited, if any, access to computers, the internet, printers, or text books they spend a lot of time (and I really mean a LOT of time!) copying out notes freehand. Usually from other students’ notes, rather than from source material.                    

I was honoured to be invited to their graduation ceremony, but unfortunately it was after I would be returning to the UK, and to be invited to a lunch-time fellowship meeting, which I found to be very moving.                   

Some of the students have also formed a group called “HAFT”(Health Advocators FINS Team). Against a background of the reluctance of the local villagers to seek medical advice, increased cases of malaria, prevalence of HIV/Aids, high infant mortality rates, poor take-up of child vaccination, or ante natal care, incidences of domestic violence and child abuse, and alcoholism.  These students visit remote local villages and use their knowledge to promote health education, good hygiene, sanitation, safe-sex, mosquito nets, basic health screening, and support and encourage villagers to seek medical help. It is amazing work, tackling really difficult issues, by such young people who have so little themselves and are in full-time study.                     


So:

  • was my trip worthwhile? Most definitely.

  • Did the Amalthea Trust look after me? Certainly.

  • Was it hard work? Yes.

  • Did I enjoy it? YES!

  • Would I do it again?  Tomorrow.       

Dave Robinson (Engineer at United Lincolnshire Hospitals NHS Trust, and Amalthea Trust Volunteer).

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